{
  "resourceType" : "Provenance",
  "id" : "ExampleTDProvenanceTDCase1.1",
  "meta" : {
    "profile" : ["https://fhir.by/StructureDefinition/ProvenanceTemporaryDisability"]
  },
  "extension" : [{
    "url" : "https://fhir.by/StructureDefinition/OrganizationReference",
    "valueReference" : {
      "reference" : "Organization/9ad86c36-0f29-428d-b476-c8603a7cdd1f"
    }
  }],
  "target" : [{
    "reference" : "EpisodeOfCare/ExampleTDCase1.1"
  }],
  "recorded" : "2023-10-11T12:47:00Z",
  "patient" : {
    "reference" : "Patient/ExamplePatientPetrovAG"
  },
  "agent" : [{
    "extension" : [{
      "url" : "https://fhir.by/StructureDefinition/ProvenanceAgentStatus",
      "valueBoolean" : false
    }],
    "who" : {
      "reference" : "PractitionerRole/6ca13d48-b3b0-4efd-89e4-0b0c7c9838dd"
    },
    "onBehalfOf" : {
      "reference" : "PractitionerRole/3c057f8d-4369-4c5e-86be-f710dff3a91c"
    }
  }]
}